Dyspnea as a dominant clinical manifestation in a patient with takotsubo cardiomyopathy treated for chronic obstructive pulmonary disease and hyperthyroidism: case report

Biłan, Andrzej; Ignatowicz, Andrzej; Mosiewicz, Jerzy; Wysokiński, Andrzej

doi:10.20452/pamw.672

Cited by 5 publications

(1 citation statement)

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“…It has also been postulated that hyperthyroidism predisposes to Takotsubo cardiomyopathy by acting synergistically with adrenergic hormones in states of catecholamine excess (8). Indeed, when we investigated previous case reports regarding the association of Takotsubo cardiomyopathy and thyrotoxicosis, several cases of Takotsubo cardiomyopathy were found to be complicated with thyrotoxicosis ( Table 2) (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). All cases were shown to present typical signs of Takotsubo cardiomyopathy (23).…”

Section: Discussionmentioning

confidence: 94%

Congestive Heart Failure Secondary to a TSH-Secreting Pituitary Adenoma Aggravated by Takotsubo Cardiomyopathy in an Elderly Patient

Sakuma

Koide

Yoshida

et al. 2018

AACE Clinical Case Reports

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Objective:To review a case of congestive heart failure (CHF) due to a thyroid-stimulating hormone (TSH)secreting pituitary adenoma (TSH-oma) concomitant with Takotsubo cardiomyopathy in an elderly patient.Methods: We describe the clinical course, laboratory data, imaging studies, and management of the patient and provide a brief literature review regarding Takotsubo cardiomyopathy associated with hyperthyroidism.Results: A 76-year-old woman was admitted to our hospital for CHF treatment. Chest X-ray and electrocardiogram (ECG) showed cardiomegaly and broad T-wave inversion, respectively. Furthermore, left ventricular angiogram and subsequent coronary angiogram showed mild hypokinesis of the apex, without signs of obstructive coronary disease. Pulmonary hypertension was determined through right-heart catheterization. Accordingly, we clinically diagnosed this patient with Takotsubo cardiomyopathy complicated with pulmonary hypertension. Administration of β-blockers and angiotensin-receptor blockers markedly improved the abnormal ECG findings and wall motion due to Takotsubo cardiomyopathy. However, the cardiomegaly and pulmonary hypertension remained. We then detected hyperthyroidism with inappropriate TSH secretion. Brain magnetic resonance imaging revealed a pituitary macroadenoma, suggesting hyperthyroidism due to TSH-oma. Octreotide administration immediately led to the normalization of thyroid hormone secretion, which in turn improved the hyperthyroidism, cardiac enlargement, and pulmonary hypertension. Transsphenoidal surgery was safely performed. Pathologic investigation confirmed the diagnosis of TSH-oma.Conclusion: We report a rare case of Takotsubo cardiomyopathy complicated with hyperthyroidism due to TSH-oma in an elderly patient. Clinically, CHF is an important sign of hyperthyroidism in the elderly. Octreotide administration could be useful for the peri-operative management of elderly patients with TSH-omas and cardiovascular complications. (AACE Clinical Case Rep. 2018;4:e115-e123) Abbreviations: CHF = congestive heart failure; ECG = electrocardiogram; LAR = long-acting release; SITSH = syndrome of inappropriate thyroid-stimulating hormone secretion; TRH = thyrotropin-releasing hormone; TSH = thyroidstimulating hormone; TSH-oma = thyroid-stimulating hormone-secreting pituitary adenoma; TR-PG = tricuspid regurgitation pressure gradient e116 Heart Failure Due to TSH-oma, AACE Clinical Case Rep. 2018;4(No. 2)

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Section: Discussionmentioning

confidence: 94%

Congestive Heart Failure Secondary to a TSH-Secreting Pituitary Adenoma Aggravated by Takotsubo Cardiomyopathy in an Elderly Patient

Sakuma

Koide

Yoshida

et al. 2018

AACE Clinical Case Reports

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Stress-induced cardiomyopathy associated with ipratropium bromide therapy in a patient with chronic obstructive pulmonary disease

Melão

Nunes

Vasconcelos

et al. 2014

Revista Portuguesa de Cardiologia

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Stress-induced cardiomyopathy, also known as 'broken heart syndrome' or Takotsubo cardiomyopathy, is characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle, in the absence of significant coronary artery disease. We report the case of a 56-year-old male patient with chronic obstructive pulmonary disease (COPD), with stress-induced cardiomyopathy associated with the use of ipratropium bromide, administered in the context of an acute exacerbation of COPD.

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Association of Endocrine Conditions With Takotsubo Cardiomyopathy: A Comprehensive Review

Gupta

Goyal

Idrees

et al. 2018

JAHA

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Dyspnea as a dominant clinical manifestation in a patient with takotsubo cardiomyopathy treated for chronic obstructive pulmonary disease and hyperthyroidism: case report

Cited by 5 publications

References 0 publications

Congestive Heart Failure Secondary to a TSH-Secreting Pituitary Adenoma Aggravated by Takotsubo Cardiomyopathy in an Elderly Patient

Congestive Heart Failure Secondary to a TSH-Secreting Pituitary Adenoma Aggravated by Takotsubo Cardiomyopathy in an Elderly Patient

Stress-induced cardiomyopathy associated with ipratropium bromide therapy in a patient with chronic obstructive pulmonary disease

Association of Endocrine Conditions With Takotsubo Cardiomyopathy: A Comprehensive Review

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